Overcoming Pain

Why people experience chronic pain, and the power they have to de-intensify it

The Crucifixion of Chronic Pain Relief

The Vicodin tablet that died for your sins.

“Religious distress is at the same time the expression of real distress and the protest against real distress. Religion is the sigh of the oppressed creature, the heart of a heartless world, just as it is the spirit of a spiritless situation. It is the opium of the people. The abolition of religion as the illusory happiness of the people is required for their real happiness. The demand to give up the illusion about its condition is the demand to give up a condition which needs illusions.”                                        --Karl Marx, Critique of Hegel’s Philosophy of Right

Marx is often paraphrased as dismissing religion as the opium of the people, but in examining the context of that phrase, it is not difficult to appreciate that Marx felt that religion was being used by those in power as a distraction for consumption by the masses, so that the masses might forget about their true misery---and thus perhaps not revolt.

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From a socioeconomic perspective, Mr. Marx’s words demonstrate a certain prescience.

After all, consider how religion has declined in this affluent country: Churches must resort to soft rock and a come-as-you-are casualness to avoid continued attrition of members. Religion must now compete with consumerism. And you know who will win that contest.

We no longer need religion as our “illusory happiness.” After all, there is free pornography, easily accessible on our iPhones.

But what if religion truly is the opium of the people—or at least of the chronic pain patient? What if its abolition literally causes more pain in the world?

Conditions with chronic, non-life-threatening pain and fatigue remain a challenge to treat, and are associated with high health care use. Understanding psychological and psychosocial contributing and coping factors, and working with patients to modify them, is one goal of management. An individual's spirituality and/or religion may be one such factor that can influence the experience of chronic pain or fatigue. Results of a study published in 2008 in the journal “Pain Research Management” appear to support the importance of religion in pain management.

The researchers considered 37,000 individuals who suffered from chronic pain and fatigue associated with fibromyalgia, back pain, migraine headaches and chronic fatigue syndrome. They found that religious persons were less likely to have chronic pain and fatigue, while those who were spiritual but not affiliated with regular worship attendance were more likely to have those conditions. Individuals with chronic pain and fatigue were more likely to use prayer and seek spiritual support as a coping method than the general population. Furthermore, chronic pain and fatigue sufferers who were both religious and spiritual were more likely to have better psychological well-being and use positive coping strategies.

Another study was reported in 2007 in “Rehabilitation Counseling Bulletin”, which surveyed 95 persons receiving treatment for chronic pain using the Spirituality and Chronic Pain Survey (SCPS). The survey included a pain assessment, a spiritual/religious practices assessment, and questions related to spiritual/religious beliefs and attitudes. Most participants reported experiencing constant, higher-level pain. The most frequent responses to pain were taking medication (89%) and praying (61%). Results indicated the majority of respondents perceived God or a Spiritual Power as helping them cope with pain and as a source of happiness, connection, and meaning in life. A factor analysis on attitude items of the SCPS identified four factors that accounted for 60% of the variance: (a) Spiritual Connection and Meaning, (b) Spiritual Increase and Hopefulness, (c) Spiritual Decrease and Punishment, and (d) Spiritual Power. These results suggest the relevance and utility of spirituality assessment for persons who live with chronic pain.

These research endeavors appear to indicate that additional religion-spirituality research and clinical intervention with chronic pain populations is warranted for several reasons: A significant segment of the population with chronic pain uses religious and spiritual beliefs and activities to cope with pain. The lack of research on potential mediators of this relation between religion-spirituality and health in chronic pain populations leaves a large gap in our understanding of how patients think and how health care providers can help. Whether this leads to a generalized utilization of well-designed spiritual or religious behavioral interventions for patients with chronic pain, even by avowed atheists, is an amusing thing to consider this eve before Easter.

Mark Borigini, M.D., is a board-certified rheumatologist who has devoted his career to treating illnesses that cause chronic pain and disability.

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